Table 3.

Examples of problems encountered in cognitive pretesting (Round 2^*) and solutions

Example 1: Reduce list of questions to patient; mention “sex” optionally
Phase I Revision: Over the past week, have you had unusually strong urges that are hard to control? For example, have you gambled too much? Have you put things together or taken things apart over and over again? Do you think a lot about sex?	Over the past week, have you had unusually strong urges that are hard to control? Do you feel driven to do or think about something and find it hard to stop? [Give patient examples such as gambling, cleaning, using the computer, taking extra medicine, obsessing about food or sex, all depending on the patients.]
Example 2: Eliminate word confusion (“personal” problems vs. trouble sleeping)
Phase I Revision: Over the past week, have you had trouble going to sleep at night or staying asleep through the night? Consider how rested you felt after waking up in the morning.	Over the past week, have you had trouble going to sleep at night or staying asleep through the night? Consider how rested you felt after waking up in the morning.
0: Normal: No problems	0: Normal: No problems.
1: Slight: Problems are present but usually do not cause trouble getting a full night of sleep.	1: Slight: Sleep problems are present but usually do not cause trouble getting a full night of sleep.
2: Mild: Problems usually cause some trouble getting a full night of sleep.	2: Mild: Sleep problems usually cause a few difficulties getting a full night of sleep.
Example 3: Medical Terminology
Phase I Revision:	Phase IA Revision:
0: Normal: Not at all. I have no tremor.	0: Normal: Not at all. I have no shaking or tremor.
1: Slight: Tremor occurs but does not cause problems with any activities.	1: Slight: Shaking or tremor occurs but does not cause problems with any activities.

^*Cognitive Testing was conducted in two rounds. The second round used cognitive pretesting to assess questions that had been revised due to problems identified in the round one, and included cognitive testing of the patient-completed version of the MDS-UPDRS.